Healthcare Provider Details

I. General information

NPI: 1457403644
Provider Name (Legal Business Name): FREDERICK ONCOLOGY HEMATOLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 BTHOMAS JOHNSON DRIVE SUITE 200
FREDERICK MD
21702-4300
US

IV. Provider business mailing address

46 THOMAS JOHNSON DRIVE SUITE 200
FREDERICK MD
21702-4300
US

V. Phone/Fax

Practice location:
  • Phone: 301-695-6777
  • Fax:
Mailing address:
  • Phone: 301-695-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. A ZAKARIA HEGAZI
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 301-695-6777